Individual provider Active NPI

Breanna Rae Lambach, DC

  • Chiropractor
  • Plymouth, MN
National Provider Identifier
1356813588
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6561 Issued in MN
Practice address
3140 Harbor LN N Ste 102
Plymouth, MN 55447-5118
Phone
(763) 230-7333
NPI assigned
Dec 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6561 MN Primary

Addresses

Primary practice location

3140 Harbor LN N Ste 102
Plymouth, MN 55447-5118

Mailing address

3140 Harbor LN N Ste 102
Plymouth, MN 55447-5118
Phone (763) 230-7333

Other identifiers 1

IdentifierTypeStateIssuer
6561OtherMNCHIROPRACTIC BOARD

Other names 1

  • Breanna Rae Adams Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240902000128 WI Practitioner - Chiropractic 9234463373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McNally Spinal Care LLCGroup PAC ID 4789674268, 4 clinicians

Practice addresses (Care Compare)

1021 Berry Ave
Tomah, WI 54660-3400
Phone (608) 372-5900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6561MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Living Well Chiropractic, P.C. Past Accepting new patients
Living Well Chiropractic, P.C. Chiropractor Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1356813588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 HARBOR LN N STE 102",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554475118",
            "telephone_number": "763-230-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 HARBOR LN N STE 102",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554475118",
            "telephone_number": "763-230-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBACH",
        "first_name": "BREANNA",
        "middle_name": "RAE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-28",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC BOARD",
            "identifier": "6561",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREANNA",
            "last_name": "ADAMS",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.